Despite the challenges for surgeons in private practice — including rising costs, declining reimbursements and administrative hurdles — the autonomy, work-life balance and close patient relationships are some of the benefits that can make it worthwhile.
Four spine surgeons shared with Becker's why they will not be leaving private practice anytime soon.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker's invites all spine surgeon and specialist responses.
Next week's question: What would it take for you to sell your spine practice?
Please send responses to Alan Condon at email@example.com by 5 p.m. CST Wednesday, March 23.
Editor's note: The following responses were lightly edited for style and clarity.
Question: What's the most difficult decision you've had to make in your career as a spine surgeon?
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: It would take an apocalyptic event. This journey has been one we all have worked so hard to get to where we are that I am not sure anyone could care for our patients in the same way. Regardless, I feel we can do a better job and take better care of our patients in a way that they are accustomed to and what they have come to expect.
Richard Kube, MD. Prairie Spine & Pain Institute (Peoria, Ill.): It would take an act of God. It has never been better to be independent. I have no plans to sell in the future.
Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): Absolutely nothing. This is my second year in solo practice. I love the independence and the ability to take care of my patients the best way I can. I only wonder why I didn't start this earlier.
Issada Thongtrangan, MD. Microspine (Scottsdale, Ariz.): For me, it is a time when the practice no longer is the autonomy-providing blessing it once was. Sometimes physician-owners continue to work the medical practice until they grow tired of the grind (i.e. declining reimbursements, burdensome government regulations, etc.) and finally reach that point when they say, "It's time." Another important consideration is burnout. This can have very negative impacts on productivity and the medical practice value.
Running a practice requires a significant investment by a physician-owner, and this is generally more by way of their time than actual capital. Physician-owners are generally passionate, driven individuals who love what they are trying to achieve. If they do not reach the "I'm over it" stage mentioned above, a physician-owner will generally stick with it until they can no longer physically keep up. This happens when it is finally time for them to retire or sell the practice.